Rational use of medicines – what’s it got to do with animals?

Yesterday I took a trip to London to meet a friend who is over from Australia. We first met about 20 years ago through an international network of independent medical publications that aimed to promote the rational use of medicines. In 1985, the World Health Organization defined the rational use of medicines as follows: “Patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community” (WHO 2002).

I’ve been giving some thought to the relevance of this definition to veterinary medicine. The first part of the definition is easily applied to animals because it’s logical that animals should only receive treatments appropriate to their clinical needs and in the right doses for the right amount of time. The next part of the definition is more tricky, unless cost is taken to mean harm, as in the adverse effects of medicines on animals. It follows that the rational use of medicines is linked to animal welfare.

Irrational use includes using medicines inappropriately, using more medicines than are needed and using medicines that cause more harm than equally effective alternatives. The causes of irrational medicines use are complex, and around the world there can be various contributory factors, such as lack of medicines regulation, restricted availability of medicines, lack of public understanding of the benefits and risks of medicines, and over-reliance on promotional information. In the UK, we’re fortunate to have medicines regulation (although it may not be perfect) and good access to the medicines we need, but public understanding about medicines and the influence of promotion are real challenges for us.

My Australian friend is now involved in establishing an important new international organisation – the International Society to Improve the Use of Medicines (ISIUM). It is a network, a think tank and a forum for the exploration of ways of knowing about medicines, their wise use and their role in society, health and illness. I have decided to support this new organisation by becoming a member. The health of humans, animals and ecosystems are interconnected, as is recognised through the One Health Initiative. Likewise, there are interconnections and common issues related to the use of medicines in humans and animals. They include

antimicrobial resistance;

the use of medicines in animals to prevent zoonotic diseases;

harms to humans through contact with veterinary medicines;

harms to the environment through use and disposal of veterinary medicines.

There are also other compelling reasons to pay attention to the use of medicines in animals:

medicines are being used increasingly to treat acute and chronic diseases in animals;

animals are at risk of harm from the adverse effects of medicines;

promotion of medicines;

the development of the evidence-based veterinary medicine movement, which brings new challenges.

Maybe in time a veterinary interest group can develop within ISIUM. Membership is open to anyone who is interested in improving the use of medicines. Find out more here: www.isium.org.